title: The outcomes of using colistin for treating multidrug resistant Acinetobacter species bloodstream infections.
abstract: Despite the identification of Acinetobacter baumannii isolates that demonstrate susceptibility to only colistin, this antimicrobial agent was not available in Korea until 2006. The present study examined the outcomes of patients with multidrug resistant (MDR) Acinetobacter species bloodstream infection and who were treated with or without colistin as part of their regimen. The colistin group was given colistin as part of therapy once colistin became available in 2006. The non-colistin group was derived from the patients who were treated with other antimicrobial regimens before 2006. Mortality within 30 days of the onset of bacteremia occurred for 11 of 31 patients in the colistin group and for 15 of 39 patients in the non-colistin group (35.5% vs 38.5%, respectively, P = 0.80). Renal dysfunction developed in 50.0% of the 20 evaluable patients in the colistin group, but in 28.6% of the 35 evaluable patients in the non-colistin group (P = 0.11). On multivariate analysis, only an Acute Physiological and Chronic Health Evaluation II score ≥ 21 was associated with mortality at 30 days. This result suggests that administering colistin, although it is the sole microbiologically appropriate agent, does not influence the 30 day mortality of patients with a MDR Acinetobacter spp. bloodstream infection.
authors.affiliation: Department of Respiratory and Critical Care Medicine, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Seung-Kwan
authors.initials: SK
authors.lastname: Lim
authors.forename: Sang-Oh
authors.initials: SO
authors.lastname: Lee
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jae-Phil
authors.initials: JP
authors.lastname: Choi
authors.forename: Sung-Han
authors.initials: SH
authors.lastname: Kim
authors.forename: Jin-Yong
authors.initials: JY
authors.lastname: Jeong
authors.forename: Sang-Ho
authors.initials: SH
authors.lastname: Choi
authors.forename: Jun Hee
authors.initials: JH
authors.lastname: Woo
authors.forename: Yang Soo
authors.initials: YS
authors.lastname: Kim
mesh_terms: D018806:APACHE; D000150:Acinetobacter / Q000187:drug effects* / Q000302:isolation & purification; D000151:Acinetobacter Infections / Q000188:drug therapy* / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy* / Q000401:mortality; D002648:Child; D003091:Colistin / Q000008:administration & dosage / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial / Q000187:drug effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D003091:Colistin